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found, and the remedies in general use are of doubt-
ful value. Hexamethylenamine may possibly have
curative properties.
7. Hookworm Disease in Mines in California.
— Gunn says that hookworm disease is endemic in
certain mines of California. From fifty' to eighty
per cent, of those working in these mines are in-
fected. The infection undoubtedly is present in
practically all of the gold mines of California, and
in those just over the border of Nevada. He be-
lieves that hookworm disease is endemic in many
mines in various parts of the United States. In
many of the so called cold mines, portions are found
where the temperature is constantly high and mois-
ture is present. In all probability most of the mines
of the country have been exposed to infection, for
in nearly all of them may be found Hungarians.
Austrians, Italians, or Cornishmen, some of whom
are certain to have brought the infection with them
from the mines of their countries.
MEDICAL RECORD
January 28, igil.
1. Personal Experience with a Very Restricted Diet
(Rice) in Acute Inflammatory Disease of the Skin,
By L. Duncan Bulkley.
2. The Surgical Aspects of Filariasis,
By Charles F. Stokes.
3. Camphor in Large Doses in Pneumonia,
By Leonard Weber.
4. Infant Mortality in New York City,
By Wilbur C. Phillips.
5. Concealed Chancre of tlie Male Urethra, with a Study
of Thirty-eight Cases, By Charles M. Whitney.
6. Treatment of Peritonitis Consecutive to Appendicitis,
By J. J. Buchanan.
7. Inebriety, Its Treatnic-nt and Curability,
By T. D. Grot HERS
I. Rice Diet in Inflammatory Diseases of the
Skin. — Bulkley describes his own case: On Au-
gust 20th he began to suffer with itching and ten-
sion in the right hand with deep papulovesicles
about the root of the little finger, necessitating the
removal of a ring. This increased, day by day,
affecting other fingers, also of the left hand. By
the 24th he was exceedingly uncomfortable, and
deep seated vesicles had formed on the sides of the
middle finger, third, and little finger of both hands,
also small, deep seated vesicles on the backs of some
of the fingers and on the back of the right hand.
As he had had a similar trouble at about the same
season of the year for a number of years past, he
did not pay much attention to it, but used some
simple remedies, including a calamine and zinc lo-
tion, which had been of some service in former at-
tacks. When the eruption first occurred, some
years ago, he attributed it to poison ivy, which was
abundant around his country home, but after a year
or so this was excluded, as the eruption did not run
the course of that trouble, and also he had sedulous-
ly avoided all contact with the vine. Nor did the
disease seem to be eczema, for the whole course
of the eruption had always been diff'erent from that
aft'ection, and, even at its height or afterward, there
had never been any tendency whatever to develop
eczematous surfaces ; when bullae formed they were
tense and hard, with very thick coverings which
were ruptured only with great difficulty, and often
became somewhat haemorrhagic. Nor did the erup-
tion quite correspond to the course and appearance
of dysidrosis or pompholyx. As it seemed, in other
years, to come on late in the summer, when he had
eaten many peaches, he sometimes ascribed it pos-
sibly to that cause ; but this year he had eaten hard-
ly a single peach. He could attribute it only to
.some gouty and nervous condition, to which he was
subject; curiously enough, it aft'ected mainly the
ulnar side of both hands, or at least its greatest in-
tensity was there. He placed himself on greatly
restricted diet, consisting solely of rice, boiled in
water, bread, butter, water, and absolutely nothing
else. This diet he continued for five days, at each
meal, three times daily. He used no other medical
treatment, external or internal, except that he con-
tinued a mild mixture of potassium acetate, nux
vomica, and quassia, which he had been taking for
some time as a tonic, and which had had no eft'ect
on the eruption. The result of this sudden and
radical change in the diet was remarkable ; within
twenty-four hours the tension, warlock spell slot free together with the
burning and itching of the hands, was lessened, and
there were no spasms of itching. In forty-eight
hours there was further marked improvement, and
he had very little discomfort, even on washing and
wiping the hands. By the end of four days the
blebs were flaccid and the swelling of the hands
quite gone; there had been no new production of
lesions after instituting the diet, and the disease
seemed entirely checked. He continued the abso-
lute diet, however, for one day more, in order to
complete the five days which he had commonly
found it best for patients to maintain strictly this-
PITH OF CURRENT LITERATURE.
241
plan of treatment". One week later most of the sur-
faces badly afifected had exfoliated, leaving- smooth,
almost normal skin.
6. Treatment of Peritonitis Consecutive to
Appendicitis. — Buchanan concludes from his ex-
perience that cases in which the pus is generally
diffused among the coils of the bowel, without any
or with insignificant adhesions, peritonitis having
existed for not longer than two days, are best treat-
ed by removal of the appendix, dry mopping of fluid
within easy reach, and closure without peritoneal
drainage. The mortality here is insignificant. So
far no cases of this character have been lost in the
writer's experience by the closed method. Cases
in which, in addition to general diffusion, there is
pocketing of pus here and there through the peri-
toneal sac, will react diiTerently according to the
general condition present. It is essentia! that all
enclosing adhesions be released and that the pocket-
ed pus be taken care of by dry mopping or turned
into the general cavity where it will be absorbed in
favorable cases. In cases far gone with sepsis, on
the other hand, this procedure is followed by a
quickly fatal result. Cases in which diflfuse peri-
tonitis still exists, but the physical signs point to an
impending localization which will almost surely con-
vert the case into one of localized abscess, may be
left to the Ochsner treatment. These are the three
and four day cases, and only the most careful dis-
crimination will serve to distinguish them from the
progressive ones with multiple foci. As experience
with the closed method increases the Ochsner cases
become rarer. warlocks spell slots Patients apparently moribund, in
whom resistance has all but ceased, with blue, leaky
skin, thready or absent pulse, subnormal temperature,
and barrellike abdomen, with loss of peristalsis, have
nearly all died, whatever the treatment ; the few ex-
ception? being saved by a waiting policv with sub-
sequent localization and drainage of abscesses.
BRITISH MEDICAL JOURNAL
Janimry 21. njli.